Provider Demographics
NPI: | 1376044040 |
---|---|
Name: | LOMA LINDA UNIVERSITY |
Entity Type: | Organization |
Organization Name: | LOMA LINDA UNIVERSITY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SR. VP, FINANCE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RODNEY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NEAL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 909-558-4543 |
Mailing Address - Street 1: | 25455 BARTON RD STE 208A |
Mailing Address - Street 2: | |
Mailing Address - City: | LOMA LINDA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92354-3177 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 909-558-6977 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 25455 BARTON RD STE 208A |
Practice Address - Street 2: | |
Practice Address - City: | LOMA LINDA |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92354-3177 |
Practice Address - Country: | US |
Practice Address - Phone: | 909-558-6977 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-02-27 |
Last Update Date: | 2018-02-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty | |
No | 2251C2600X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Cardiopulmonary | Group - Single Specialty |
No | 2251G0304X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics | Group - Single Specialty |
No | 2251H1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Hand | Group - Single Specialty |
No | 2251H1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Human Factors | Group - Single Specialty |
No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology | Group - Single Specialty |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | Group - Single Specialty |
No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Single Specialty |